Sequelae to torture. A controlled study of torture victims living in exile

Twenty-eight Turkish refugees living in Denmark were examined by the authors in the period 1984-85. Fourteen of the persons alleged having been tortured in Turkey during the period 1980-83. The remaining 14 persons reported that they had not been tortured and thus acted as controls. All the testimonies were found valid according to a method previously used by us. The most common forms of violence reported were blows and electrical torture. Blindfolding, solitary confinement and threats were also frequent. At the time of examination the main mental complaints were sleep disturbances with nightmares and impaired memory. Emotional lability and concentration disturbances were also frequent. Physically the torture victims suffered from headache, various cardio-pulmonary and muscular pains, dyspepsia and reading disturbances. All reported that they had been healthy before torture. The clinical examination revealed only a few signs related to torture, although examples of minimal scars, fractured or missing teeth, discrete neurological disorders and mental depression were found. The 14 controls had significantly fewer complaints, and almost no abnormalities were found during the clinical examination. The present study clearly demonstrates the traumatic effects of torture.     

Physical and psychological sequelae to torture. A controlled clinical study of exiled asylum applicants

The study comprised 24 male Lebanese refugees living in Denmark. Twelve of them alleged having been tortured in Lebanon during the period 1981-85. The remaining twelve had neither been imprisoned nor tortured and thus acted as control persons. All the testimonies were found to be valid according to a method previously used by the author. The most common forms of torture were blows against the head, body and foot soles, suspension and asphyxiation. Threats and solitary confinement were frequent, and sexual violations were also reported. At the time of examination (March-November 1986), the main complaints were headaches, various cardiopulmonary symptoms, sleep disturbances with nightmares, impaired concentration and memory, and emotional lability. Suicide attempts were reported. Prior to the torture all the probands had been healthy except for several cases of gunshot wounds. The clinical examination revealed different scars possibly related to torture in nearly all the cases. Missing or fractured teeth, peripheral nerve damage and mental depression were also found. The 12 controls had several mental and physical complaints, but significantly fewer than the probands. Almost all of them had scars from gunshot wounds. The present study clearly indicates that torture plus exilation has a more deteriorating effect on the health status than exilation alone.     

Medical/health histories and physical evaluation of physically and sexually abused child psychiatric patients: A controlled study

This study examines findings from a pediatric health history and child physical examination conducted for 105 outpatient and 105 inpatient children who were classified on the basis of their history of physical and sexual abuse. Based on multivariate and univariate analyses, physically abused children had more early developmental delays, neurologic soft signs, serious physical injuries, skin markings and scars, and stimulant drug use than their non-physically abused peers. Sexually abused children were reported to exhibit higher levels of sexual activity and stimulant drug use, and had more physical signs of genital manipulation than non-sexually abused children. These data highlight the need to further examine the impact of medical and developmental aberrations, the nature and origins of recurrent physical injuries in this population, and the extent of risk-taking in understanding the differences between physical and sexual child maltreatment.     

Factors moderating physical and psychological symptoms of battered women

Physical and psychological symptoms of battered women were investigated based on the theory that their ongoing victimization would produce stress-related symptoms. It was hypothesized that moderating variables (e.g., frequency and severity of abuse, predictability and controllability of abuse, social support networks) would influence the effects of abuse. Battered women (N = 234) were interviewed according to a structured format which allowed for behavioral indices of the data and categorization of the women's responses. Results indicated that frequency of abuse was a strong predictor of the number and severity of symptoms. Those women who could predict abuse experienced more symptoms. Severity of physical and psychological symptoms was predicted by a model including women with more injuries requiring medical attention, women adhering to traditional sex role values, and the presence of one type of emotional abuse. Battered women perceived their physical and emotional health as deteriorating during the relationship and during the abuse, but as getting healthier after the abuse ended. Future research needs to replicate these findings with a representative group of battered women who are still in the battering relationship.     

Mental and physical health symptoms of family court intimate partner violence petitioners

This paper explores the impact of intimate partner violence on victim health and proposes interdisciplinary coordination between legal and mental health services as a means to assist victims. Data was collected from 95 female petitioners at an upstate New York Domestic Violence Intensive Intervention Court (DVIIC). Study participants completed surveys on physical health, mental health, and social functioning. Survey results demonstrated decreased mental health and social functioning as well as a strong willingness to utilize court-based mental health services if offered. Findings from this study support court-based settings as appropriate sites for addressing mental health needs through collaborative efforts between legal and mental health professionals.     

Betrayal trauma: associations with psychological and physical symptoms in young adults

Betrayal trauma, or trauma perpetrated by someone with whom a victim is close, is strongly associated with a range of negative psychological and physical health outcomes. However, few studies have examined associations between different forms of trauma and emotional and physical symptoms. The present study compared betrayal trauma to other forms of trauma as predictors of young adults' psychological and physical symptoms, and explored potential mediators. A total of 185 university undergraduate students completed the Brief Betrayal Trauma Survey, the Trauma Symptom Checklist, the Toronto Alexithymia Scale, and the Pennebaker Inventory of Limbic Languidness. For each set of symptoms, simultaneous multiple regressions assessed the relative contributions of low versus high betrayal trauma to psychological and physical health reports. Structural equation models examined traumatic stress symptoms and alexithymia as mediators of the relationship between betrayal trauma and physical health symptoms. A total of 151 participants (82%) reported exposure to at least 1 of 11 forms of trauma queried (M = 2.08, SD = 1.94); 96 participants (51.9%) reported at least 1 betrayal trauma. Traumas characterized by high betrayal predicted alexithymia, anxiety, depression, dissociation, physical health complaints, and the number of days students reported being sick during the past month, whereas other traumas did not. Structural equation modeling revealed that traumatic stress symptoms and alexithymia mediated the association between betrayal trauma and physical health complaints. These results indicate that betrayal trauma is associated with young adults' physical and mental health difficulties to a greater extent than are other forms of trauma. Results may inform assessment, intervention, and prevention efforts.     

以精神发育迟滞女性为性侵害对象的强奸犯的智力水平与智力结构的对照研究

目的研究强奸精神发育迟滞女性的强奸犯与强奸正常女性的强奸犯在智力水平与结构方面的差异.方法前者33例,后者32例,采用WAIS-RC评估其智力水平与结构.结果两组在总体智商、言语智商、操作智商方面均有显著性差异.11项分测验中数字广度、木块、图片3项在两组间无显著性差异,其余8项均有显著差异.结论强奸精神发育迟滞女性的强奸犯与智力低下有关,他们在智力结构方面也存在着异常.     

A controlled study of the time-course of breath alcohol concentration after moderate ingestion of ethanol following a social drinking session

This paper evaluates the breath alcohol concentration (BrAC), nausea (feeling of being slightly intoxicated) and subjective driving performance after ingesting a moderate dose of alcohol in the presence of a light meal, which intends to approach a social drinking setting. 119 healthy individuals (69 males and 50 females, aged 21.7+/-3.0) ingested three glasses of wine (95mL each) and their BrAC was determined by an Alcotest 7410 at 15, 30, 45, 60, 90 and 120min post-drinking. 46% of females and no male subjects exceeded a BrAC of 0.25mg/L, the legal limit for driving fixed by some Western countries. 53% of the study population felt nausea during the experimental session and 20% self-reported impairment of their driving skills. In both cases these subjective effects were more pronounced in females. The major determinants of mean BrAC were time post-drinking, gender (male) and body mass index (BMI), all these variables being inversely associated. Females and individuals with a BMI lower than 22.5kg/m(2) were at an increased risk of exceeding the legal limit of BrAC. The feeling of nausea was significantly associated with gender (females), the ingestion of up to 2 drinks on weekdays, and having exceeded a BrAC of 0.25mg/L during the experimental study. The main predictor of self-perception of impaired driving skills was the feeling of nausea, followed by a BrAC in excess of 0.25mg/L. In conclusion, both females and subjects with lower BMI are at an increased risk of exceeding the legal limit of BrAC after moderate alcohol consumption resembling a social drinking setting.     

毛发常见机械性损伤形态的环境扫描电镜研究

目的建立环境扫描电镜(ESEM)法推断毛发致伤物种类的新方法。方法应用ESEM观察分析不同锐器、钝器及致伤方式形成的毛发机械性损伤的微观形态特征。结果毛发锐器、钝器损伤的表面微观特征存在显著差异,同种类型致伤工具,其锋利程度、作用方式不同时,其损伤特征也明显不同。结论ESEM法能够真实、自然反映毛发机械性损伤表面微观特征,可应用于推断毛发致伤物种类。     

A prospective study of predictors of violence in adult male mental health admissions

Studies of violence prediction have typically involved long-range follow-up of institutionalized persons and have shown poor predictive accuracy. In the present study a sample of adult males at risk for violent behavior admitted as inpatients at a community mental health center was followed for six months after their release. Data collected at admission (which included demographics, family back-ground, criminal justice and mental health systems contacts, past violent behavior, life stress, family, friendship, and work environment measures, psychiatric diagnosis, and alcohol and drug use) were used to predict subsequent violent arrests or readmissions using stepwise discriminant analysis. Results yielded 85% of the total sample correctly classified. Of those predicted to be nonviolent 94% were actually nonviolent and of those predicted to be violen 59% were actually violent. Seventy-six percent of the violent subjects were identified. Implications of the findings for clinical predictions of violence are discussed.     

A prospective study of pathways to hospital readmission in Canadian forensic psychiatric patients

Individuals admitted to secure care often experience lengthy hospitalizations and are likely to be admitted on more than one occasion. In the context of growing demand and costs associated with secure care, the current study investigates the frequency and reasons for readmission among 87 forensic patients recently discharged into the community. We identify risk factors that are associated with the likelihood of readmission and describe areas of overlap and discordance with the existing literature in civil and forensic samples. Using a prospective design that included patient follow-up interviews and records review, we found that 28% of patients were readmitted on one or more occasions over a 12-month period. Psychiatric decompensation, substance use, and treatment non-adherence were the central reasons prompting readmission. Patients with one or more readmissions were found to have spent significantly more time in the forensic mental health system as compared to patients not readmitted. They were more likely to have a substance use disorder and were estimated to be at higher risk for violence. Results replicate the finding of low rates of serious violence and reoffending among discharged forensic patients, and substantiate the centrality of substance use as a growing and clinically important treatment issue.     

Documentation of torture and cruel,inhuman or degrading treatment of children: A review of existing guidelines and tools

The documentation of individual cases of child torture is of paramount importance to bring justice to, and help heal, individuals and sensitize societies. Our objective is to systematically review medical guidelines for the recording of individual cases of child torture or cruel, inhuman or degrading treatment (CIDT). We searched CINAHL, Embase, the Guidelines International Network, Lilacs, Medline, the National Guideline Clearinghouse, PsychInfo and all websites of the organizations participating in the updating of the Istanbul Protocol for guidelines or studies on how to document torture, CIDT or abuse in persons under 18 years. We did not find a comprehensive guideline that encompassed all aspects of the documentation of child torture, as does the Istanbul Protocol for adults. An expert opinion guideline on how to document sexual torture in children was found, and in addition we identified 13 consensus-based guidelines for the evaluation of abuse in children or specific aspects thereof. We strongly recommend a child specific, comprehensive guideline on the documentation of torture and CIDT in children.     

Blood and sperm traces on human hair. A study on preservation and detection after 3-month outdoor exposure

Hair can retain important biological traces for forensic investigations. Forensic scientists are used to looking for such traces on clothing and skin of victims, however, when decomposition kicks in and all that remains of the victims is the skeleton, hair may be the only tissue representing the surface of the body at the time of a crime on which biological traces of an aggressor may have been left and still be detectable. Given the lack of research on this topic, this pilot study aims to assess the capacity of hair to retain semen and blood in hair, and the possibility to detect these fluids with well-known techniques and to obtain a useful genetic profile even when exposed to environmental conditions (Open Natural Environment (woods), Open Man Made Environment (urban)) for three months.Results showed that both traces were always visible and detectable with almost all techniques in the Control Environment, while in the two open environments some difficulties arose. However, biomolecular analysis was effective up to three months on both fluids in the Natural Environment and up to two months and one week respectively on blood and semen in the Man Made Environment. The Combur Test, OBTI, and Luminol were effective on blood up to three months in both environments while Sperm-HY-Liter and observation of cellular components were effective on semen up to at least 1 month and PSA testing was positive up to 1 week in both environments.The present work can be considered an encouraging starting point for the analysis of biological traces on hair in forensic contexts, regardless of the PMI, since blood and semen related to a crime may survive.     

A target glitter study.

A target study was conducted using four different pre-selected types of commercial glitter particles. Recipient areas in the general environment around San Diego, California were tested. Glitter particles were recovered using double-sided tape affixed to square plastic Petri dishes. White light microscopy was the only search/identification method used. Additionally, a test was performed of the transferability of cosmetic glitter. Glitter particles were found to readily transfer. Of a total of 48 tape lifts from the general environment, 23 were found to contain at least one glitter particle. But due to the wide variety of glitter particles in terms of colour, shape, size, and surface morphology, the likelihood of transfer of one or more specific target particles was small.